Adarsha S Bajracharya1, Bradley H Crotty2, Hollis B Kowaloff2, Charles Safran2, Warner V Slack2. 1. Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, USA adarsha@bidmc.harvard.edu. 2. Division of Clinical Informatics, Beth Israel Deaconess Medical Center, 1330 Beacon St., Suite 400, Brookline, MA 02446, USA.
Abstract
OBJECTIVE: Health care proxy (HCP) documentation is suboptimal. To improve rates of proxy selection and documentation, we sought to develop and evaluate a web-based interview to guide patients in their selection, and to capture their choices in their electronic health record (EHR). METHODS: We developed and implemented a HCP interview within the patient portal of a large academic health system. We analyzed the experience, together with demographic and clinical factors, of the first 200 patients who used the portal to complete the interview. We invited users to comment about their experience and analyzed their comments using established qualitative methods. RESULTS: From January 20, 2015 to March 13, 2015, 139 of the 200 patients who completed the interview submitted their HCP information for their clinician to review in the EHR. These patients had a median age of 57 years (Inter Quartile Range (IQR) 45-67) and most were healthy. The 99 patients who did not previously have HCP information in their EHR were more likely to complete and then submit their information than the 101 patients who previously had a proxy in their health record (odds ratio 2.4, P = .005). Qualitative analysis identified several ways in which the portal-based interview reminded, encouraged, and facilitated patients to complete their HCP. CONCLUSIONS: Patients found our online interview convenient and helpful in facilitating selection and documentation of an HCP. Our study demonstrates that a web-based interview to collect and share a patient's HCP information is both feasible and useful.
OBJECTIVE: Health care proxy (HCP) documentation is suboptimal. To improve rates of proxy selection and documentation, we sought to develop and evaluate a web-based interview to guide patients in their selection, and to capture their choices in their electronic health record (EHR). METHODS: We developed and implemented a HCP interview within the patient portal of a large academic health system. We analyzed the experience, together with demographic and clinical factors, of the first 200 patients who used the portal to complete the interview. We invited users to comment about their experience and analyzed their comments using established qualitative methods. RESULTS: From January 20, 2015 to March 13, 2015, 139 of the 200 patients who completed the interview submitted their HCP information for their clinician to review in the EHR. These patients had a median age of 57 years (Inter Quartile Range (IQR) 45-67) and most were healthy. The 99 patients who did not previously have HCP information in their EHR were more likely to complete and then submit their information than the 101 patients who previously had a proxy in their health record (odds ratio 2.4, P = .005). Qualitative analysis identified several ways in which the portal-based interview reminded, encouraged, and facilitated patients to complete their HCP. CONCLUSIONS:Patients found our online interview convenient and helpful in facilitating selection and documentation of an HCP. Our study demonstrates that a web-based interview to collect and share a patient's HCP information is both feasible and useful.
Authors: Warner V Slack; Hollis B Kowaloff; Roger B Davis; Tom Delbanco; Steven E Locke; Charles Safran; Howard L Bleich Journal: J Am Med Inform Assoc Date: 2012-01-11 Impact factor: 4.497
Authors: H L Bleich; R F Beckley; G L Horowitz; J D Jackson; E S Moody; C Franklin; S R Goodman; M W McKay; R A Pope; T Walden Journal: N Engl J Med Date: 1985-03-21 Impact factor: 91.245
Authors: Adarsha S Bajracharya; Bradley H Crotty; Hollis B Kowoloff; Charles Safran; Warner V Slack Journal: J Am Med Inform Assoc Date: 2019-07-01 Impact factor: 4.497
Authors: Hillary D Lum; Adreanne Brungardt; Sarah R Jordan; Phoutdavone Phimphasone-Brady; Lisa M Schilling; Chen-Tan Lin; Jean S Kutner Journal: J Pain Symptom Manage Date: 2018-10-25 Impact factor: 3.612
Authors: Sarah R Jordan; Adreanne Brungardt; Phoutdavone Phimphasone-Brady; Hillary D Lum Journal: Am J Hosp Palliat Care Date: 2019-02-25 Impact factor: 2.500